Thank you to Dr. Garsson for his kind comments on our article. We agree with his comments that occlusal forces and prematurities are part of the multi-factorial etiology of vertical root fractures, or VRFs.
As we wrote in the third paragraph of our article, research has shown that clenching and bruxism are certainly contributing factors. To what extent occlusal prematurities and para-functional occlusal habits contribute to VRFs is difficult to apportion. We must consider occlusion more comprehensively for our patients, not just how it relates to an individual tooth, but rather how it relates to the entire masticatory complex.
How we design our fixed and removable prostheses and how they might relate to the whole dentition, especially to a restoratively compromised tooth, can be an important issue in preventing VRFs. This would relate to all teeth, not just those that have been endodontically treated.
